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Pain in tail bone following Pelvic Radiotherapy

KezC
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It's been a full year since my treatment for anal cancer, where I had combined radiotherapy and chemotherapy. My 6 month scan showed the tumour had gone. About 9 months post treatment I started getting a pain in my tailbone when sitting for long periods, I'm office based with my work so do sit for a long time, however most recently this pain is getting worse and it's there nearly all the time, the only relief is lying down or standing, also when it's really severe after a long day it feels like I need to empty my bowels when there is nothing there. I've contacted my GP who didn't examine me, we spoke over the phone and said it could be side effects of the radiotherapy and wanted to prescribe me morphine, which I declined. I want to get to the source of what's causing the pain and treat the source if this can be done rather than masking the pain with painkillers. Is my pain likely to be from the radiotherapy, and one of the side effects I need to live with, will my oncologist look into what's causing the pain, or am I stuck with this for the foreseeable and my only option is the strong pain killers offered by my GP

  • Dear KezC,

    Thank you for getting in touch.  My name is Kelly and I’m one of the Cancer Information Nurse Specialists.

    I’m sorry to read about your symptoms.  I can see that you have already joined our Anal cancer forum and I hope you have found this supportive at this time.

    As we’re not directly involved with your care or able to assess any symptoms fully here this makes it difficult for us to guide you about what is the main cause of this is.

    However, the level of pain you are experiencing does sound concerning especially about how severe this is for you and the changes in sensation to your bowel.

    When someone mentions these types of symptoms to us, we have to make sure we are exploring with you all potential causes associated with back pain after treatment for cancer.  Some may sound more worrying than others, but it is just to make sure that you are able to get the best support moving forward.

    As you mentioned you could be experiencing what is know as late effects of radiotherapy to the pelvic area.  This can sometimes cause changes such as bone thinning which can make them more fragile and prone to pain.  This area is very sensitive to muscle injury which could be affected by sitting for long periods too.

    Sometimes worsening pain and bowel problems can be a sign of a more worrying condition called a spinal cord compression.  This happens when cancer cells grow into the spine and press on the nerves in the bone.  This is very rare but important to be aware of.

    We’re not saying this is happening- especially due to the 6-month scan showing the tumour was clear-  but it is important to be cautious to get the best support and advice when speaking to any healthcare professionals directly involved with your care today.

    Getting medical advice immediately is always recommended if it isn’t clear what the cause of any worsening pain is.

    It is important that you get back in touch with your consultant, named anal cancer nurse specialist and GP for an urgent face to face assessment of the pain today to understand the best way to manage this. This may include taking stronger painkillers such as morphine if appropriate.

    They can arrange any further tests, such as an MRI scan to try and establish what is likely to be causing this if needed.

    If you are unable to get in touch with anyone today the advice for someone with worsening back pain when it isn’t clear what is causing this is to go to A&E.

    As it is important just now to make sure that you start to get in touch with any doctors and nurses directly involved with your care, I will let you go to do that just now.

    However, please don’t hesitate to get back in touch for further support at any time if needed.

     Take care and best wishes,

    Kelly (Cancer Information Nurse Specialist)

     

    You can also speak with the Macmillan Support Line team of experts.  Phone on 0808 808 0000 (7 days a week, 8am-8pm) or send us an email or use webchat.

    Ref: KA/KHa

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